Provider Demographics
NPI:1033306832
Name:WHITLOCK STREETS, JOANNA-DAWN ALBERTA (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:JOANNA-DAWN
Middle Name:ALBERTA
Last Name:WHITLOCK STREETS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 E 6TH STREET
Mailing Address - Street 2:APT 5J
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:225 E 6TH ST
Practice Address - Street 2:APT 5J
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-8263
Practice Address - Country:US
Practice Address - Phone:207-215-6379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-26
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics